MIDFLORIDA SURGE Business Incubator Application

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MIDFLORIDA SURGE Business Incubator Application - 2023

To apply for the MIDFLORIDA SURGE program, presented by The Well, please answer the following questions. To complete your application, you will need to submit a response to all the questions. Please direct any questions to the attention of The Well MIDFLORIDA SURGE Program via email: thewell.lakeland@gmail.com.

Email *

Please provide your name. *

Please provide your age group. *

MIDFLORIDA SURGE supports diversity among entrepreneurs. Are you represented by one of the following. *

Female entrepreneurs

Underserved populations

Under-represented groups

I am not represented by these groups.

Required

Please provide your business name. *

Please provide the number of years you have been in business. *

Within what industry does your business operate? *

What is your business structure? *

Do you have business partners? *

Yes

Do you have paid employees (including yourself)? *

Yes

Please provide the social media accounts and/or website for your business. If you do not have these, please state why. *

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